Stakeholders across health care, including patient representatives, providers, and associations unite to advocate for high needs accountable care to continue beyond 2026
Washington, D.C. (April 22, 2025) – Ten Accountable Care Organizations (ACOs) – along with Accountable for Health (A4H), the American Academy of Home Care Medicine (AAHCM), America’s Physician Groups (APG), the Coalition to Transform Advanced Care (C-TAC), the National Association of ACOs (NAACOS) – are launching a new Alliance focused on improving models of care for the most complex and vulnerable Medicare beneficiaries. The Complex Care Alliance, comprises participants in the High Needs ACO model and concerned organizations that are advocating for the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center to strengthen and continue the model beyond its current expiration date in 2026.
Established under the Global and Professional Direct Contracting model launched under the Trump Administration, which is now known as ACO Realizing Equity Access and Community Health (REACH), the High Needs model was designed to provide high-quality, coordinated care for Medicare’s sickest patients. The model includes specific flexibilities and design elements tailored to the unique needs and characteristics of these patients, who have an average of 12 chronic conditions and nearly 70 percent of whom are dually eligible for Medicare and Medicaid.
The High Needs ACO model has already demonstrated its ability to improve patient outcomes and reduce costs for this population. According to CMS data, 14 High Needs ACOs saved about $143 million in 2023, a 13.3% net savings rate. The Complex Care Alliance is committed to working with CMS and the Innovation Center to ensure Medicare beneficiaries have continued access to high-needs focused accountable care that meaningfully improves quality of life and reduces program spending.
“Accountable for Health is proud to support the launch of the Complex Care Alliance and its mission of improving care for our sickest and most vulnerable patients,” said Mara McDermott, CEO, Accountable for Health. “High-needs patients require proactive, team-based care that is impossible to deliver under a fee-for-service payment system. These organizations have proven that accountable care models deliver better care at reduced costs for this highly specialized population, and we plan to build on this success for years to come.”
“At the American Academy of Home Care Medicine, we see firsthand the critical role that home-based primary care plays in supporting Medicare’s most medically complex patients,” said Dr. Tom Lally, Chairman of the Public Policy Committee at AAHCM. “The High Needs ACO model empowers providers to deliver the proactive, person-centered care these patients need to thrive at home and avoid unnecessary hospitalizations. AAHCM is proud to join the Complex Care Alliance in advocating for the continuation and strengthening of this model to ensure our most vulnerable patients receive the care they deserve.”
“We are delighted to partner with our colleagues in the Complex Care Alliance,” said Susan Dentzer, MS, President and CEO of America’s Physician Groups. As an organization representing multiple ACO REACH participants, APG has been “especially gratified to see such strong performance among our High Needs participants as they serve older adults with significant chronic or other serious illnesses and signs of frailty,” Dentzer added. These Medicare beneficiaries are frequently hospitalized if they don’t obtain preventive care, and in performance year 2023, the quality score for average days at home for these frail beneficiaries in High Needs ACOs improved by more than 5 percentage points. “These results constitute proof of concept that the interventions possible through the High Needs model achieve real results for patients,” Dentzer said.
“ACO REACH is one of the most promising models for patients with serious illness,” said Jon Broyles, CEO of the Coalition to Transform Advanced Care (C-TAC). “We cannot let it sunset in 2026. That’s why we’re supporting the launch of the Complex Care Alliance.”
“Accountable care models enable providers to deliver more personalized, proactive care—especially for those with the most complex needs,” said Emily Brower, CEO of the National Association of ACOs (NAACOS). “We are proud to join the Complex Care Alliance as our members embrace its collective mission to ensure Medicare’s most vulnerable beneficiaries have access to the high-quality, coordinated care that ACOs are uniquely positioned to provide.
The 10 High Needs ACOs in the Complex Care Alliance are: Advanced Illness Partners, Bloom Healthcare, CareConnnect MD, Curana Health, Ennoble Care, Essen Health Care, HarmonyCares, Intrinsia Health, Provider Partners Connect Care, and Theoria Medical.
To learn more about the Complex Care Alliance, please visit: https://accountableforhealth.org/cca/.
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Media Contact:
Lindsay Hebert
Devaney & Associates
443-471-5103
